Tang Hsin-Ju, Tsai Shiau-Ting, Chou Fan-Hao
School of Nursing, Kaohsiung Medical University, ROC.
Hu Li Za Zhi. 2013 Dec;60(6):35-46. doi: 10.6224/JN.60.6.35.
Studies have shown that cardiovascular rehabilitation exercise improves quality of life in post-coronary-bypass-surgery patients. However, the rate of participation in this exercise by this patient group in Taiwan has increased only 8.2% during the past 13 years (from 61.9% in 1996 to 70.1% in 2009). Little is known about the factors that influence patient motivation to participate in cardiovascular rehabilitation exercise.
This study explores the factors that influence patient participation in rehabilitation exercise following coronary bypass surgery.
This cross-sectional, correlational study recruited a convenience sample of 253 patients who had undergone coronary bypass surgery at a medical center in southern Taiwan. Structured questionnaires, including a patient rehabilitation exercise experience questionnaire, Short Form-36 Health Survey-Taiwan Form, and cardiac rehabilitation exercise design factors questionnaire were used for data collection. SPSS19.0 was used to analyze data.
The variables "healthcare provider recommendation of rehabilitation exercise", "exercise program accessibility", "physical health status", and "patient post-surgical exercise patterns" each had a significant influence on participant participation in post-surgical rehabilitation exercise. Binary logistic regression analyses identified "receiving information on rehabilitation exercise", "level of patient-perceived importance of rehabilitation exercise", and "having post-surgical exercise patterns" as important predictors of participation in a rehabilitation exercise program, with OR ratios of 112, 7.86, and 3.23 times respectively. These 3 factors accounted for 90.1% of the total variance.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Patient education on coronary bypass post-surgical rehabilitation exercise programs should be emphasized during pre-surgical consultation and care in order to facilitate the recovery of normal life functions following coronary bypass surgery.
研究表明，心血管康复运动可改善冠状动脉搭桥手术后患者的生活质量。然而，在过去13年中，台湾地区该患者群体参与此项运动的比例仅增长了8.2%（从1996年的61.9%增至2009年的70.1%）。对于影响患者参与心血管康复运动积极性的因素，人们了解甚少。
本研究旨在探究影响冠状动脉搭桥手术后患者参与康复运动的因素。
本横断面相关性研究选取了台湾南部一家医疗中心253例接受冠状动脉搭桥手术的患者作为便利样本。采用结构化问卷收集数据，包括患者康复运动经历问卷、台湾版简明健康调查问卷-36项和心脏康复运动设计因素问卷。使用SPSS19.0进行数据分析。
“医护人员对康复运动的推荐”“运动项目的可及性”“身体健康状况”和“患者术后运动模式”这几个变量均对参与者术后康复运动的参与情况有显著影响。二元逻辑回归分析确定“接受康复运动信息”“患者对康复运动重要性的认知程度”和“有术后运动模式”为参与康复运动项目的重要预测因素，其比值比分别为112、7.86和3.23倍。这3个因素占总方差的90.1%。
结论/对实践的启示：在术前咨询和护理过程中，应着重对冠状动脉搭桥手术后的康复运动项目进行患者教育，以促进冠状动脉搭桥手术后正常生活功能的恢复。
